Transplant Trial Watch

Randomized clinical trial of non-antibiotic prophylaxis with d-Mannose plus Proanthocyanidins vs. Proanthocyanidins alone for urinary tract infections and asymptomatic bacteriuria in de novo kidney transplant recipients: The Manotras study.

Rau, M., et al.

Nefrologia (Engl Ed) 2024 [record in progress].

This study aimed to examine whether 24-h prolonged release formulation of d-Mannose combined with Proanthocyanidins (PAC) was safe and effective in preventing urinary tract infections (UTI) and asymptomatic bacteriuria (AB) following kidney transplantation.

Participants were randomised to d-Mannose plus PAC or PAC alone.

60 de novo kidney transplant recipients.

The primary outcome was the composite endpoint of the incidence of UTI and/or AB during a follow-up period of 6 months post-transplantation. The secondary outcomes included global incidence of UTI and/or AB, types of UTIs, microbiological characteristics, kidney allograft function, patient survival, graft survival, incidence of double J colonization, delayed graft function (DGF), rate of rejection, and incidence and type of adverse events.

6 months post-transplantation

CET Conclusions
d-Mannose and Proanthocyanidins (PAC) have both been shown to play a role in preventing UTI in animal models and healthy women. This randomised trial compared the combination of d-Mannose and PAC to PAC alone in patients who had kidney transplant. There was no difference in any of the outcomes between the two groups. Furthermore, as there was no placebo comparator group, this study provides no compelling evidence to suggest that the use of either agents would prevent UTI in kidney transplant patients.

Jadad score

Data analysis
Per protocol analysis

Allocation concealment

Trial registration - NCT05109455

Funding source
Non-industry funded